Tuesday

Nov 6, 2018 at 10:14 AMNov 6, 2018 at 10:49 AM

When you dial 911 in an emergency, you expect qualified trained professionals to come to your aid.

According to the results of an investigation into Armstrong Ambulance, which has been located in Arlington for 72 years, by the state Department of Public Health’s (DPH) Office of Emergency Medical Services (OEMS), at least five paramedics falsified training records for advanced cardiac life support (ACLS), cardiopulmonary resuscitation (CPR) and Pediatric Advanced Life Support (PALS).

Allegations against the five paramedics were filed with the DPH in April and May of 2018, referencing incidents that occurred in the fall and winter of 2017.

The result of the investigation concluded that “Armstrong failed to ensure the validity of ...credentials, in violation of the EMS Systems regulations and had in place a process that allowed this type of false obtaining of credentials required for EMT certification to occur.”

Armstrong currently services 17 communities in Greater Boston, including Saugus. Armstrong Ambulance originally partnered with the Town of Saugus in October 2016 to provide secondary ambulance services throughout the remainder of the town’s contract with American Ambulance, and this past spring Armstrong became the sole ambulance service provider for the Town of Saugus.

According to a statement from Armstrong Ambulance's Chief Business Officer Meredith Lambroff, the employees who oversaw the training programs are no longer employed by Armstrong.

Falsification at the highest level

According to the report from DPH, an unnamed complainant reported that Raymond was added to a class roster, dated March 13, 2017, for an ACLS recertification class without the instructor’s knowledge.

According to the DPH report, emergency medical technicians (EMT) are required to renew their certificates every two years. They must meet training requirements based on their level of certifications.

Raymond, recertifying as an EMT-Paramedic, was required to successfully complete and document CPR and ACLS training, which must be obtained through an instructor-led course or blended learning experience with an in-person, hands-on skills evaluation.

Documentation of completed training must then be submitted through the DPH web-based continuing education tracking platform.

The complainant alleged that there was no documentation of Raymond’s practical skills assessment, while there was for the other 12 students in the class, and the documentation for the written test was different than the exam given to the other 12 students.

According to an interview between OEMS investigator Renee Atherton, documented in the investigation, Raymond acknowledged he did not attend the ACLS class held on March 13, 2017 but could not recall how his name was added to the roster.

He told Atherton that he did not sign his own name, according to the report.

Raymond said that he told Scott Morency, Armstrong Ambulance’s clinical coordinator at the time, that his ACLS certification needed to be renewed and that Morency gave him the written test and later observed his hands-on skills evaluation.

He told Atherton he assumed Morency completed the documentation for his skills evaluation and could not recall who he gave his completed written test to.

The DPH investigation noted that there is no documentation of Raymond having completed this skill evaluation.

After receiving an electronic ACLS certification, Raymond said on March 13, 2017 he submitted his recertification on the DPH web-based tracking platform and renewed his Massachusetts paramedic certification based on this course.

"Running out of time"

According to a second report from DPH, a complaint was also filed against Armstrong Ambulance paramedic and Chief Information Officer James Brooks, alleging he falsified training records for ACLS and CPR recertification, adding his name to the roster of a class he did not attend.

Ricardo Gomez, a Woburn firefighter who taught the CPR class Brooks was on the roster for, told Atherton he held a class on March 9, 2018 for four students.

Brooks was not one of them.

Gomez said he did not add Brooks’ name to the roster and assumed it was added by someone at Armstrong Ambulance, according to the report.

Morency told Atherton that Brooks approached him on or around March 28, 2018 and said he was completing his ACLS recertification and needed to do the skills assessment portion, according to the report. Morency said he arranged to meet with Brooks on March 30 to complete the skills assessment.

Morency added that he was called away the morning of March 30 and never met with Brooks, stating that the did not ask what Brooks did that day because he did not feel it was his responsibility and if Brooks needed to reschedule, he would let him know.

Brooks said later on March 30, Morency called him and said he “was all set.”

Armstrong Ambulance Training Center Coordinator Carla Iannetta told Atherton in an interview that Brooks approached her several times asking about a CPR roster for him to sign to recertify his CPR certification and said she provided him with Gomez's roster to sign.

According to the report she, “felt pressured by him to accommodate his request,” and “stated she was aware that Brooks was preparing to complete the requirements for paramedic recertification and he was running out of time to meet the deadlines.”

Iannetta said in her interview she received an email from Brooks on or around March 28 with his certificate of completion for the online, written portion of Brooks’ ACLS evaluation and assumed he had completed the skills assessment as well.

Brooks’ skills assessment listed Morency as the reviewer. Both Morency and Iannetta told Atherton that in the past, Iannetta had typed Morency’s name in as the instructor for him because he was often not available to sign off himself.

Brooks said he felt like he was “running out of time” to complete his paramedic recertification and said he was uncertain about whether he wanted to get recertified, according to the report.

Brooks told Atherton he “has not been staffing an ambulance for approximately eight years and does not intend to in the future,” and “is embarrassed this happened at all, and that he has never done this before.”

The complainant reported that the three paramedics were the only ones signed up for the PALS class, dated Oct. 21, 2017, and the class was never held.

According to the report, PALS courses can be used for continuing education credit towards paramedic recertification but are not required to renew a Massachusetts paramedic certification.

Armstrong Ambulance does, however, require all of its paramedics to maintain current PALS certification as a condition of employment, according to the report.

All three paramedics told Atherton they were given the written portion of the recertification test prior to the skills assessment. Carroll and Mangan said Iannetta gave them the written test sometime in October and Fors said it was on his desk sometime that same month.

They all told Atherton they did not place their names on the roster for the class, according to the report.

Iannetta told Atherton that she may have given the three paramedics the written test, but did not recall who told her to do this. According to the report, she said she knew this was wrong and was not the way the recertification is usually done, but she did it anyway.

Morency said he observed each of the three paramedics perform the skills assessment individually but did not administer the written test or complete documentation for the skills assessment.

He added that he did not know any roster had been created and did not hold a formal class.

Only Fors submitted this PALS training towards his continuing education requirements for his paramedic recertification.

Licenses handed over, revoked

In an email to DPH on May 20, 2018, Brooks voluntarily surrendered his paramedic certification and his National Registry of EMTs (NREMT) paramedic certification.

According to the Massachusetts Health Professions License Verification site, Brooks’ instructor/coordinator license was also voluntarily surrendered.

In a letter dated June 19, 2018, Raymond told DPH he was voluntarily surrendering his Massachusetts paramedic certification and his (NREMT).

Mangan and Carroll are currently certified paramedics; they retook and completed a valid PALS class and received valid PALS certification.

According to the Massachusetts Health Professionals License Verification site, Fors’ license was revoked.

In response to the DPH findings, Armstrong’s Director of Operations Michael Kass submitted a plan of correction. He also completed a retrospective review of Armstrong’s ACLS and CPR recertification programs and did not find any questionable documentation and believed Brooks’ incident was isolated.

As of June 6, 2018, Armstrong Ambulance no longer provides American Heart Association (AHA) courses, such as PALS, CPR and ACLS, and will use Professional Ambulance Service as its AHA training center for its emergency medical services personnel.

"We have cooperated fully with every requirement and recommendation of the Massachusetts Office of Emergency Medical Services (OEMS) during this process," Lambroff said in her statement to The Advocate. "OEMS took no adverse action against Armstrong Ambulance’s license, and in August during our annual license renewal inspection, OEMS gave Armstrong a positive evaluation and noted zero serious deficiencies."